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Dr. Frank, Board Certified Physician

Category: Neurology

Satisfied Customers: 8999

Experience: Board certified general Adult Neurologist, with experience in experimental neuroimaging and neurodiagnostics.

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I have 3 cm X 3 cm arachnoid cyst left middle cranial fossa.

Customer Question

I have 3 cm X 3 cm arachnoid cyst left middle cranial fossa. I now have nausea at times pressure feeling in my head. I have severe fatigue, drooling on one side of mouth, and hand tremor on opposite side, balance problems. I also have had some severe tics. Worst of all cognitive decline (which I have neuropsych. Testing already done) would this require surgical treatment or not?

Hello Welcome to JA. I will review your statement and leave you a preliminary answer, you can review that and then ask questions, I will be here to respond. Ask questions until you are satisfied, then if you are, please remember to rate my answer as that is how I get compensation

would you have your MRI report? Did you ever have appreciable head trauma, or meningitis/infection as a child? Any family history of arachnoid cysts? If you have your neuropsych testing, could you upload the summary, which tests did they do and the result of each test? Did you get an eeg as part of your evaluation? get back to me and then I will try to give you a better answer. Dr Frank

Hi Well thank you for all that information. That helps. Have you had an EEG (brain wave test)? Based on your images that you sent ( I didn't get to see all of the MRI) I would say that you do not need surgery. You have a "tip of the temporal lobe" arachnoid cyst. There is no pressure being put on the brain with your cyst You can think of your cyst as a fluid filled space which is there because the brain is not quite large enough to fill up the inside of your skull Without evidence of fluid pressing on the brain, there would be no reason to shunt the fluid out of your skull to your abdominal cavity. Now, I say that not knowing your clinical story. If your facial weakness with drooling, the tremor, your balance, if all of that is getting worse with time, then you may need a surgery to shunt off the cerebrospinal fluid, or do a fenestration procedure on the dura mater to allow for self absorption of the cerebral spinal fluid.

so the answer to your question is from here, looking at your images and not knowing how you are changing, I would say you do not need surgery. Please get back to me with questions if I can help. Please remember to rate my answer if satisfied as that is how I am compensated for my work. Dr Frank

Hello. I hope I was able to answer your question. please get back to me with additional questions if you have them, or if satisfied, please remember to rate my answer as this is how I am compensated for my work Just click on the stars. Dr Frank